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Predicting Posttraumatic Stress Disorder Symptoms During Adolescence: A Longitudinal Study of The Role of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction

Description: Posttraumatic stress disorder (PTSD) is a trauma-related disorder that may develop in response to traumatic or stressful events. Dysfunction of the Hypothalamic-Pituitary-Adrenal (HPA) axis has been implicated in the disorder. Studies support such dysfunction as being a consequence of PTSD, rather than a precursor. However, most studies of the HPA are either cross-sectional or have been carried out in adults. The aim of the present study was to identify whether HPA dysregulation interacts with stressful experiences to increase the likelihood of developing PTSD symptoms in a community-recruited sample of healthy adolescent girls. Adolescent girls (N = 550) and one of their parents participated. Adolescents’ clinical symptoms were assessed at baseline and at a nine month follow-up. Saliva samples were collected from all adolescent participants at waking, 30 minutes after waking, and 8 pm on 3 consecutive days. Flattened diurnal slope of cortisol at baseline was associated with increased PTSD symptoms nine months later. Baseline cortisol awakening response (CAR) per se was not prospectively related to developing PTSD symptoms, but its interactions with stressful experience was associated with elevated PTSD symptoms at follow-up. Effects were small and need to be replicated in samples with more severe stressors, as well as more clinical levels of PTSD. Nevertheless, findings suggest that dysregulated basal HPA functioning may be involved in the development of PTSD symptoms.
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Date: May 2016
Creator: Liu, Keke
Partner: UNT Libraries

An Examination of a Framework for Posttraumatic Stress Disorder Correlates: Exploring the Roles of Narrative Centrality and Negative Affectivity

Description: Recent estimates suggest that a large percentage of the population experiences some type of traumatic event over the course of the lifetime, but a relatively small proportion of individuals develop severe, long-lasting problems (e.g., posttraumatic stress disorder; PTSD). One major goal for trauma researchers is to understand what factors contribute to these differential outcomes, and much of this research has examined correlates of posttraumatic stress disorder (PTSD) symptom severity. An important next step in this line of research is the development of conceptual frameworks to foster a deeper understanding of the relationships among these diverse predictors of PTSD and their predictive power in relation to each other. A framework proposed by Rubin, Boals, and Hoyle centers on the influence of narrative centrality (construal of a traumatic experience as central to one's identity and to the life story) and negative affectivity (the tendency to experience negative emotion and to interpret situations and experiences in a negative light), suggesting many variables may correlate with PTSD symptoms via shared variance with these two factors. With a sample of 477 participants recruited from Amazon Mechanical Turk, this dissertation project extended the work of Rubin and colleagues by a) utilizing structural equation modeling techniques to simultaneously examine relationships among variables, b) investigating the utility of the model with a carefully-selected list of PTSD correlates, c) extending the model by including PTSD symptom severity, and d) exploring both direct and indirect effects to assess the roles of narrative centrality and negative affectivity as they relate to known PTSD correlates and PTSD symptom severity. PTSD correlates included social support quality and quantity, peritraumatic dissociation, negative posttraumatic cognitions, perceived injustice, and negative religious coping. Hypotheses were partially supported, and there was some evidence that the model may be effective in distinguishing between variables more and less germane to ...
Date: August 2016
Creator: Southard-Dobbs, Shana
Partner: UNT Libraries

The Strength of a Witness: Empowerment and Resiliency in the Aftermath of Atrocity

Description: Victims and witnesses that testify before an international criminal tribunal such as the International Criminal Tribunal for the Former Yugoslavia (ICTY) willingly subject themselves to scrutiny and bare their wounds before the world. Does this experience cause these vulnerable individuals undue psychological harm, re-traumatization, or worse? Existing literature indicates this may be the case, however using a new dataset I find the opposite to be true. Witnesses at the ICTY report feeling more positive than negative after their experiences on the stand. As the first systematic study on witness mental wellbeing, these findings contradict expectations found in previous research.
Date: December 2016
Creator: McKay, Melissa
Partner: UNT Libraries

An Initial Validation of the Virtual Reality Stroop Task (VRST) in a Sample of OEF/OIF Veterans

Description: Currently, neuropsychologists rely on assessment instruments rooted in century old theory and technology to make evaluations of military personnel’s readiness to return-to-duty or return to their community. The present study sought to explore an alternative by evaluating the validity of a neuropsychological assessment presented within a virtual reality platform. The integration of a neuropsychological assessment into a cognitively and emotionally demanding virtual environment – reminiscent of a combat experience in Iraq – offers a more ecologically valid manner in which to evaluate the cognitive skills required in theater. U.S. military veterans’ (N = 50) performance on the Virtual Reality Stroop Task (VRST) was compared with performance on a paper-and-pencil, a computer adapted version of the Stroop task, and the subtests included in the Automated Neuropsychological Assessment Metrics-4 (ANAM4) TBI-MIL test battery. Results supported the validity of the VRST, indicating it demonstrates the typical Stroop effect pattern. The emotional salience of the VRST resulted in slowed reaction time compared to the ANAM Stroop. Further, the complex interference condition of the VRST offers opportunities for evaluation of exogenous and endogenous attentional processing. In the evaluation of threat, participants were noted to perform more accurately and more quickly in low threat versus high threat zones. Ancillary inquiries found no clinically meaningful findings regarding the role of deployment or post-concussive symptoms, and mixed findings regarding the effect of posttraumatic stress symptoms on neuropsychological performance among the three tested modalities.
Date: August 2015
Creator: Feil Johnson, Stephanie
Partner: UNT Libraries

Contributing Factors in the Development of Complex Post-traumatic Stress Disorder Among Survivors of Interpersonal Violence

Description: An understanding of factors that contribute to Complex Post Traumatic Stress Disorder (CPTSD) is of considerable importance to inform the prevention and treatment of the disorder. Moreover, gaining a better understanding of the factors that contribute to the etiology of CPTSD is of interest since most research to date focuses on the etiology of PTSD. Therefore, the purpose of the current study is to test the hypothesized prediction between childhood exposure to violence, childhood attachment, current interpersonal factors, and CPTSD symptoms. Using data from a community clinic and shelter serving victims of domestic violence and sexual assault, a partial least squares path analysis approach was employed to test the model’s strength in predicting contributing factors of CPTSD. Results support the proposed model, however, an alternative and more parsimonious model was found to be superior and revealed relationships between interpersonal variables and CPTSD. Specifically, women who reported child abuse and poor attachment with either parent, a perceived lack of current emotional and tangible support, and recent intimate partner violence (IPV) also reported symptoms of CPTSD. However, other variables, such as adult attachment avoidance and anxiety did not influence IPV or CPTSD as expected. Ultimately, the current findings lend support for Herman’s (1992) original conceptualization of CPTSD symptoms observed in survivors of prolonged and repeated trauma. Implications of these findings are discussed and results highlight the importance of assessing the contextual factors (e.g., social support, family environment) when a victim of prolonged trauma comes for treatment. Lastly, treatment implications and specific points of intervention are presented.
Date: August 2015
Creator: Marchesani, Estee Simpkins
Partner: UNT Libraries

Development of a Self-Report Measure of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) According to the Eleventh Edition of the International Classification of Diseases (ICD-11): The Complex Trauma Inventory

Description: The work group editing trauma disorders for the upcoming edition of the International Classification of Diseases (ICD-11) made several changes. Specifically, they significantly simplified the guidelines for post-traumatic stress disorder (PTSD) and added a new trauma disorder called complex PTSD (CPTSD). The new domains for PTSD and the addition of CPTSD require new instruments to assess these novel constructs. We developed a measure of PTSD and CPTSD (Complex Trauma Inventory; CTI) according to the proposed ICD-11 domains, creating several items to assess each domain. We examined the factor structure of the CTI (using both exploratory and confirmatory factor analyses) in two separate samples of diverse college students (n1 = 501; n2 = 500), reducing the original 53 trauma items in the item pool to 21 items. Confirmatory factor analyses supported two highly-correlated second-order factors (PTSD and complex factors), with PTSD (i.e., re-experiencing, avoidance, hyper-arousal) and complex factors (i.e., affect dysregulation, alterations in self-perception and alterations in relationships with others) each loading on three of the six ICD-11-consistent first-order factors (RMSEA = .08, CFI = .92, GFI = .87, SRMR = .06). Internal consistency for PTSD (α = .92) and complex factors (α = .93) are excellent.
Date: August 2016
Creator: Litvin, Justin M
Partner: UNT Libraries

The Effects of Resilience and Self-Compassion on Symptoms of Stress and Growth Resulting from Combat Exposure in Service Members

Description: The current study examined the impact of resilience and self-compassion on the relationship between combat exposure and psychological outcomes, specifically post-traumatic stress and post-traumatic growth. Service members and veterans with combat exposure (N = 143) completed an online survey, through which they were administered a Background Questionnaire, the Combat Exposure Scale, the PTSD Checklist for DSM-5, the Posttraumatic Growth Inventory, the Connor-Davidson Resilience Scale, and the Self-Compassion Scale. Results of a path analysis revealed a positive direct effect of combat exposure on post-traumatic stress symptoms and post-traumatic growth and a negative direct effect of self-compassion on post-traumatic stress symptoms. Furthermore, self-compassion moderated the relationship between combat exposure and post-traumatic growth. Implications of these findings and future directions for research are discussed.
Date: May 2017
Creator: Raiche, Emily
Partner: UNT Libraries

Mediational Roles of Personality Factors and Vengeful Rumination in the Development of Posttraumatic Stress Disorder

Description: Considerable research has demonstrated a link between thoughts of revenge, or vengeful rumination, and the development of posttraumatic stress disorder (PTSD) symptoms, particularly in situations involving interpersonal trauma. Personality factors have been related to both vengefulness and PTSD. No study to date has simultaneously examined the unique contributions of vengefulness and personality factors in the development of PTSD symptoms. Therefore, the present study addressed these questions in an inpatient sample by comparing contributions of the Big Five personality factors and vengeful rumination to the development of PTSD symptoms through correlation, hierarchical regression, and omnibus regression analyses. Results showed that Neuroticism predicted PTSD symptoms better than other personality factors, that Neuroticism and Agreeableness predicted vengeful rumination in opposite directions, and that personality factors and vengeful rumination each added unique variance in the prediction of PTSD symptoms. Future directions and implications are discussed.
Date: August 2009
Creator: Crostley, Jeremy T.
Partner: UNT Libraries

Posttraumatic Stress Disorder (PTSD): What is it and what causes it?

Description: This presentation is part of the faculty lecture series UNT Speaks Out on Coming Home. The author has a grant from the National Institute of Health (NIH) and the National Institute of Mental Health (NIMH) on innovative approaches to understanding and treating PTSD. In this presentation, the author discusses PTSD and other responses to trauma and stress.
Date: November 15, 2012
Creator: Boals, Adriel
Partner: UNT College of Arts and Sciences

Assessment of Feigning with the Trauma Symptom Inventory: Development and Validation of new Validity Scales with Severely Traumatized Patients

Description: Currently, only the TSI assesses complex traumatic reactions and patient response styles. However, its feigning scale, ATR, uses a flawed detection strategy and is potentially confounded by experiences of complex PTSD. As a consequence, clinicians using the TSI to evaluate severely traumatized patients have no useful method for discriminating genuine and feigned responding. Several detection strategies have demonstrated utility within evaluations of feigned trauma including the assessment of rare symptoms, symptom combinations, symptom selectivity, and symptom severity. The current study created scales on the TSI according to these strategies using a development sample of 107 severely traumatized patients. Validation of all TSI feigning scales was then performed with a second independent sample of 71 severely traumatized patients using a mixed simulation design. Results found support for each scale's convergent validity with SIRS primary scales (M rs = .52) and discriminant validity with measures of defensiveness on the SIRS (M rs = -.07) and TSI (M rs = -.19). Each scale also produced expectedly mild to moderate relationships with SADS-C clinical scales (M rs = .32) and the SCID-IV PTSD module (M rs = -.02). Support for their criterion validity was only moderate (M ds = .69) when comparing the scores of genuine patients to those simulating disability. Potential explanations for this trend were reviewed, including (a) the impact of comorbidity, (b) the restrictions associated with creating embedded feigning scales, and (c) the influence of simulator knowledge in analogue designs. Limitations of the study and future avenues of research were discussed.
Date: May 2011
Creator: Payne, Joshua W.
Partner: UNT Libraries

Implementation of a Therapy Group for Wives of Veterans with Posttraumatic Stress Disorder: Development and Preliminary Outcomes

Description: The purpose of this study was to develop a manualized therapy group for wives or significant others of veterans with posttraumatic stress disorder and to evaluate its effectiveness in reducing wives' psychological symptoms. A second aim of the study was to determine if women's involvement in the wives group resulted in decreases in their husbands' PTSD symptoms. Women recruited for the study were administered pre-test measures during a screening session. They then participated in a 9-session manualized therapy group designed by the researcher that included psychoeducational, process, and support components. Examples of group topics included psychoeducation regarding PTSD, assertiveness and communication, intimacy, self-care, and stress management. After completing the group sessions, participants were asked to complete post-test measures. Other factors explored in this study included marital satisfaction, perceived social support, general satisfaction with the group, and demographic variables. Results indicated that wives who participated in the group treatment exhibited significant decreases in secondary stress symptoms and increases in marital satisfaction from pre-test to post-test. The majority of participants also reported high levels of satisfaction with the group process. Therefore, it appears that the group protocol presented in this study could be a useful tool in the treatment of wives of veterans with PTSD. The results of this study have potential implications regarding the clinical treatment of families of veterans with PTSD and the development of future programs within the VA system.
Date: May 2011
Creator: Reck-Gordy, Jennifer K.
Partner: UNT Libraries

The Relation of Witnessing Interparental Violence to PTSD and Complex PTSD

Description: Complex posttraumatic stress disorder (CPTSD) integrates symptoms common to victims of "complex" traumas, like childhood physical or sexual abuse, with the diagnostic criteria of posttraumatic stress disorder (PTSD). It was hypothesized that a history of witnessing interparental violence would be related to adulthood CPTSD symptoms. Results from hierarchical multiple regressions with 287 college students showed that witnessing interparental violence and experiencing child physical abuse predicted higher levels of CPTSD, PTSD, and depression symptoms. After controlling for child abuse, witnessing interparental violence predicted higher levels of traditional PTSD symptoms, but it did not predict an increase in overall CPTSD symptom severity or depression. Results suggest that the traditional PTSD construct, rather than CPTSD, best accounts for the symptoms of those who witnessed interparental violence in childhood.
Date: May 2011
Creator: Miller, Susannah
Partner: UNT Libraries

Life Beyond Betrayal: the Influence of Self-as-context on Self-complexity and Posttraumatic Stress

Description: While current research indicates that traumas high in social betrayal are more closely associated with symptoms of posttraumatic stress and identity disturbances than are traumas low in betrayal, the psychological mechanisms by which identity problems occur are less understood. The current project explored the relationships between traumas high and low in betrayal and their influence on self-complexity, through the RFT and ACT conceptualization of three types of self-experiencing: self-as-content, self-as-process, and self-as-context. The roles of experiential avoidance, dissociation, and severity of PTSD symptoms were also considered within this framework. A sample of 548 undergraduate students at the University of North Texas completed online self-report questionnaires, and results suggested that self-as-context more strongly predicted PTSD symptoms than trauma exposure, dissociation, and experiential avoidance. Moreover, high betrayal trauma was found to be a stronger negative predictor of self-as-context than low betrayal trauma. Exposure to trauma was found to significantly predict self-complexity, and self-as-context more strongly predicted self-complexity than did self-as-process. Interestingly, self-as-context did not moderate the relationship between trauma exposure and PTSD symptoms, nor between trauma exposure and self-complexity. Implications of the current study’s findings, as well as suggestions for further research related to the impact of interpersonal betrayal on the self and psychological health, are discussed.
Date: August 2014
Creator: Sinha, Aditi
Partner: UNT Libraries

Guilt and Shame as They Relate to Combat Posttraumatic Stress Disorder (PTSD): An Analysis of Trauma Content And Resulting Symptomatology

Description: This study began testing the Sewell and Williams (in press) model that differing trauma types yield differing presentations in social versus event processing domains. Other hypotheses explored trauma type with levels of guilt, and shame-proneness with anxiety. Volunteers were 44 male combat veterans being treated for PTSD. Data analyses determined whether trauma type related to guilt and perceived social support and whether shame-proneness related to levels of anxiety. High shame persons may process anxiety and social support differently than low shame persons. Results can assist professionals understand how a person's functioning is affected by certain types of trauma. Future research should focus on increasing social support for persons who have experienced trauma.
Date: May 2001
Creator: Taber, Iris
Partner: UNT Libraries

PTSD in Women following a Disaster: the Effects of Social Support and Gender Differences

Description: The purpose of this study was to examine and compare individuals that had survived a single incidence trauma, the Luby's massacre in Killeen, Texas. Participants answered questions regarding various facets of social support following the trauma, and were also screened for a diagnosis of PTSD. Participants' level of symptoms, specifically depression, anxiety, and phobic anxiety was measured over time with the SCL-90-R. The results of this study indicate that, while women initially experience a higher level of depression and phobic anxiety, there is no gender difference in rate of symptom change over time. This study also found that women were significantly higher than men on desirability, utilization and usefulness of social support. Of the target symptoms, however, only depression correlated with any facet of social support, specifically, desirability. Finally, this study questioned whether individuals would share more similarities with others based on gender or diagnosis. It is suggested by the current data that diagnosis is the better indicator of similarity.
Date: December 1996
Creator: Direiter, Diana C. (Diana Charity)
Partner: UNT Libraries

Conceptual Structure of HIV+ Women With PTSD: Trauma Construct Elaboration

Description: Human immunodeficiency virus (HIV) can result in posttraumatic stress disorder (PTSD) as events related to illness act as traumatic stressors. This study tested some basic hypotheses of Sewell and Cromwell's personal construct model of PTSD in HIV+ women both with and without diagnoses of PTSD. Trauma-related constructs of HIV+ women with PTSD with HIV+ non-PTSD controls at varying stages of illness were compared. The elaboration, rankings, and valence of trauma-related constructs were examined using the Life Events Repertory Grid (LERG) procedure. Findings provided evidence that a clinical diagnosis of PTSD in women was not associated with the degree of construct elaboration. These findings may imply a qualitative difference in cognitive processing of social stressors and violent stressors.
Date: August 1998
Creator: Jones, Deborah (Deborah Lynne), 1958-
Partner: UNT Libraries

Predictors of Posttraumatic Stress Disorder in a Community Sample of Women: Examination of the Role of Violence and Ethnicity

Description: The purpose of the current study was to examine Dutton's (1992) model of moderating and mediating variables which may impact the relationship of violence from an intimate partner with the development of posttraumatic stress disorder (PTSD) symptoms. This model was tested within three ethnic groups (African American, n = 303, Euro-American, n = 271, and Mexican American, n = 260), of low income, community women in serious, long-term relationships. The importance of the differences and similarities observed are discussed within a framework of the PTSD as well as domestic violence literature.
Date: August 1998
Creator: Vogel, Laura C. M.
Partner: UNT Libraries

Posttraumatic Stress Disorder as a Differential Diagnosis of Sexually Abused Children: a Survey of Psychologists

Description: Psychologists' diagnostic choices when the specificity of child sexual abuse in a clinical vignette is varied was examined. The degree to which Posttraumatic Stress Disorder (PTSD) was judged to be a viable diagnostic choice among a set of diagnoses was analyzed under conditions with sexual abuse stated, implied, not stated, and excluded. PTSD was rated as more likely for the stated and implied sexual abuse vignettes than for the not stated and excluded vignettes.
Date: August 1997
Creator: Gonzalez, Christine
Partner: UNT Libraries

Grace After Fire: an Analysis of Table Talk: Color Me Camo-realities of Female Veterans

Description: Beginning May of 2013 and ending in September, I worked with Grace After Fire (Grace), a virtual nonprofit organization that focuses on issues related to female veterans. Grace’s mission is to provide female veterans with the means to gain knowledge, insight and self-renewal. Grace’s mission is accomplished through peer support and resource referral. The aim of my thesis project was to conduct an analysis of Grace’s peer support system, Table Talk: Color Me Camo (Table Talk). Because Table Talk is a fairly new program for Grace, just over a year old, the outreach coordinators were eager to learn: 1) if they were indeed meeting their mission of empowering female veterans, and 2) the point-of-view of the peer facilitators who conduct Table Talk. To help Grace gain perspective, I interviewed women who had previously attended Table Talk, as well as peer facilitators responsible for coordinating the peer support system-all of whom are female veterans. The following is their story.
Date: December 2013
Creator: Phillips, Jessica Laureano
Partner: UNT Libraries

Benefits and Costs of Social Interactions Among Firefighters

Description: Despite high levels of exposure, firefighter posttraumatic stress disorder (PTSD) rates are unclear. Likewise, questions remain regarding how social interactions and beliefs about emotion might interact to influence PTSD in firefighters. In this study, U.S. urban firefighters (N = 225) completed measures of social support, negative social interactions, and fear of emotion which were then used via regression analyses to predict PTSD symptoms. Each independent variable predicted PTSD beyond variance accounted for by demographic variables. Additionally, fear of emotion emerged as the strongest individual predictor of PTSD and a moderator of the relation between social interactions and PTSD symptoms. These findings emphasize the importance of beliefs about emotion; both in how these beliefs might influence the expression of PTSD symptoms, and in how the social networks of trauma survivors might buffer distress.
Date: December 2010
Creator: Farnsworth, Jacob
Partner: UNT Libraries

Transportation trauma and psychological morbidity: Anxiety, depression, PTSD and perceived control in a hospitalized sample.

Description: Transportation-related collisions are ubiquitous and often traumatic. Identifying post-collision psychological distress and the characteristics of the collision survivor that lead to distress are vital to the development of early and appropriate interventions. The goals of this study were: 1) to use a questionnaire as opposed to a typical diagnostic interview, 2) to confirm that psychological distress is present in currently hospitalized transportation-related collision survivors, 3) to confirm that different types of distress co-occur, 4) to determine if distress is more likely to occur in those who have had prior distress, and 5) to explore the relationship between symptoms of distress and perception of control by self, others, and God/Higher Power of past, present, and future collision-related events. Subjects were 100 English speaking adult inpatients, 16 years and older, who were less than 3 weeks post-injury, and receiving some rehabilitation. Participants completed a questionnaire which included the Center for Epidemiologic Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI), and Davidson Trauma Scale (DTS) as well as questions regarding demographics, details of the collision/injury, alcohol/drug use, pain, past and present stressors, social support, and perceptions of life change. Information about head injury and collision-concurrent alcohol and/or drug use was collected from the patient's medical chart. Compared to other traumatic experiences (e.g., physical/sexual abuse, war combat), transportation-related collisions share the characteristics of being sudden, unexpected, relatively brief in duration, and potentially lethal. Prior studies used diagnostic interviews to identify psychological distress in post hospitalized collision survivors. This study used questionnaire-based depression, anxiety, and trauma symptom inventories in a currently hospitalized sample and included head injured patients. As hypothesized there was a significant correlation between the CES-D total score and the BAI total score [Hypothesis 1], the DTS total score [Hypothesis 2], and collision concurrent alcohol and/or drug use (as indicated by medical chart ...
Date: August 2007
Creator: Biggs, Quinn M.
Partner: UNT Libraries